Adsorption as a Contributor for Inflammatory Mediators Removal by Different Hemofiltration Membranes: A Pilot Study

Abstract

Atherosclerosis is an important predictor of mortality in patients with chronic kidney disease (CKD) and is associated with a wide inflammatory response. The aim of this study is to evaluate in vitro how different membranes can remove mediators associated with this pathology in a closed loop dialysis model. We performed experimental hemofiltration in vitro using three different membrane materials. Human plasma was preliminarily incubated with various inflammatory mediators and filtered in a closed loop circulation model for 240 min. Respective concentrations of 17 different mediators were measured over time to study the removal mechanisms of each membrane, including associated removal time course. The experiment was repeated three times for the assay of tumor necrosis factor (TNF)-α to document the model variability. Means were compared using Mann-Whitney test. Most of the investigated mediators were effectively removed with the different dialysis membranes. Adsorption mechanism was mainly at the origin of the decrease in mediators circulating concentrations and was maximized in the region 10 000-20 000 Da. Especially, the HeprAN membrane showed fast removal capacities of mediators with elevated isoelectric point including complement factors and chemokines or having basic groups located in the protein periphery, plasminogen activator inhibitor (PAI-1), and TNF-α-like. The latter was further significantly removed with HeprAN and polymethylmethacrylate (PMMA) compared to polyethersulfone (PES) material (P < 0.01). We concluded that dialysis using ionic adsorptive membrane could have a beneficial impact for CKD patients with atherosclerosis and would deserve further clinical investigations.

Artificial Organs 2017: A Year in Review

“…Malard et al of Baxter, Meyzieu, France evaluated in vitro how different membranes can remove mediators associated with the pathology of atherosclerosis using a closed loop dialysis model. They performed hemofiltration using three different membrane materials.…”

Large Middle Molecule and Albumin Removal: Why Should We Not Rest on Our Laurels?

“…Adsorption could be an effective technique for the removal of large toxins as convective and diffusive techniques will always be limited by membrane permeability. Indeed, it demonstrates a real impact on the removal of plenty of atherosclerotic-linked markers [16] . Nevertheless, its evaluation remains difficult to assess and standardize.…”

Adsorption kinetics of high mobility group box 1 protein in a polyacrylonitrile hemofiltration membrane

“…Although mechanistic studies of cytokine binding, including HMGB1, to adsorptive membranes have received attention and are urgently needed, 9 few studies have focused on the adsorption mechanism. 7 In this study, we hypothesized that adsorbed heparin on an AN69ST membrane surface might contribute to HMGB1 adsorption owing to the presence of a heparin-binding site on HMGB1. We also hypothesized that the filtration rate may increase the adsorption sites by pushing the molecules deeper from membrane surface into the bulk layer.…”

“…5 Recently we reported that an AN69ST hemofilter adsorbed cytokines (IL-1β, IL-8, and IL-10), which had been elevated by LPS, from fresh porcine blood. 6 Several studies have postulated that the AN69ST membrane adsorbs cytokines via electrostatic attraction between its anionic sulfonate group and the cationic amino group of the cytokines 7,8 ; however, the specific mechanism remains unknown. Although mechanistic studies of cytokine binding, including HMGB1, to adsorptive membranes have received attention and are urgently needed, 9 few studies have focused on the adsorption mechanism.…”